National Trends and Disparities in Severe Food Insecurity in Brazil between 2004 and 2018

Household food insecurity among child and adolescent athletics practitioners: A cross-sectional, descriptive, and exploratory study

OBJECTIVE

The aim of the study was to explore the prevalence of food insecurity among child and adolescent athletics practitioners and to investigate factors associated with exercise performance, dietary habits, body composition, sleep, and socioeconomic status based on food security status.

METHODS

This was a cross-sectional, descriptive, and exploratory study conducted in Campinas, São Paulo, Brazil, between June and July 2023. The convenience sample included children and adolescents (7-17 y old) of both sexes. We evaluated exercise performance, household food insecurity (HFI), dietary-related parameters, and other body composition, lifestyle, and social-related variables. Exercise performance was assessed using the counter movement jump (CMJ), squat jump (SJ), horizontal long jump (HLJ), 50-m sprint test (50-m ST) and throwing strength test (TST). The assessment of HFI was conducted using the food insecurity experience scale (FIES). Comparisons and associations were investigated based on food security status.

RESULTS

The total sample size was comprised of 138 children (n = 42; 30.4%) and adolescents (n = 96; 69.6%). We found an association between food security status and sex (X2(138,1) = 4.42; P = 0.036). SJ was higher in the food security group than in the HFI group (t(117) = 2.112; P = 0.037; ES = 0.39). Sleep- and dietary-related factors did not differ between the groups.

CONCLUSIONS

In summary, the prevalence of HFI among child and adolescent athletics participants was approximately 40%. Regarding exercise performance, SJ was better in the food security group than in the HFI group. Concerning dietary-related data, the HFI group had a lower number of meals per day than the food security group, and other dietary data did not differ between the groups. Body composition and sleep-related parameters were similar between the groups.

[Food insecurity and household water insecurity: a population-based study in a municipality in the Amazon River basin, Brazil]

This study analyzed food insecurity and associated factors in the urban area of a municipality in the Amazon River basin, Western Amazon. This is a cross-sectional population-based study conducted from August to November 2021 with 983 households selected by stratified probability sampling. A multinomial logistic regression model was used, adopting the following criteria: p-value < 20% in the bivariate analysis and p-value < 5% for the multivariate adjustment. The results of the analyses were described as odds ratio (OR) and 95% confidence interval (95%CI). The following variables were significantly associated with mild or moderate food insecurity: household water insecurity; number of residents ≥ 5 in the household; belonging to socioeconomic class D or E; having a father, mother or another as the head of the family; and having any resident as a beneficiary of the Brazilian Income Transfer Program. The analysis model for severe food insecurity showed that living with household water insecurity; belonging to socioeconomic class D or E; having a father, mother or another as the head of the family; age of the head of the family < 55 years; and family income lower that two minimum wages increased the chances of severe food insecurity when compared to those with food security. In conclusion, this study found a high prevalence of food insecurity in the Municipality of Itapiranga, State of Amazonas, North Region of Brazil, associated with social and economic vulnerability, lack of public services, and household water insecurity.

Pathways to Poor Adherence to Antiretroviral Therapy Among People Living with HIV: The Role of Food Insecurity and Alcohol Misuse

Daily adherence to antiretroviral therapy (ART) increases the length and quality of life of people living with HIV (PLHIV). We explored whether socioeconomic status directly impacts ART adherence and whether part of the effect is mediated by pathways through alcohol misuse or food insecurity. A cross-sectional study was conducted in Rio de Janeiro/Brazil (November/2019 to March/2020) with PLHIV aged ≥ 18 years. Validated instruments were used to measure alcohol use, food insecurity, and ART adherence. Using structural equation modeling we assessed the direct and indirect effects of variables on ART adherence. Participants reported significant challenges: hunger: 12%, alcohol use: 64%, and missing ART doses: 24%. Results showed that lower socioeconomic status increased poor adherence and that this effect was mediated through higher food insecurity. Alcohol misuse also increased poor adherence through a strong direct effect. Providing socio-economic support coupled with interventions to mitigate alcohol's harmful impact can aid HIV care.

Food and nutrition security definitions, constructs, frameworks, measurements, and applications: global lessons

Food security (FS) is a powerful social determinant of health (SDOH) and is crucial for human and planetary health. The objectives of this article are to (i) provide clarity on the definitions of FS and nutrition security; (ii) provide a framework that clearly explains the links between the two constructs; (iii) summarize measurement approaches, and (iv) illustrate applications to monitoring and surveillance, policy and program design and evaluation, and research, mainly based on the ongoing rich experience with food insecurity (FI) scales. A clear and concise definition of FI and corresponding frameworks are available. There are different methods for directly or indirectly assessing FI. The best method(s) of choice need to be selected based on the questions asked, resources, and time frames available. Experience-based FI measures disseminated from the United States to the rest of the world in the early 2000s became a game changer for advancing FI research, policy, program evaluation, and governance. The success with experience FI scales is informing the dissemination, adaptation, and validation of water insecurity scales globally. The many lessons learned across countries on how to advance policy and program design and evaluation through improved FS conceptualization and measurement should be systematically shared through networks of researchers and practitioners.

Poverty-Food Insecurity Nexus in the Post-Construction Context of a Large Hydropower Dam in the Brazilian Amazon

Within the 2030 Sustainable Development Agenda, large hydropower dams are positioned as a sustainable energy source, notwithstanding their adverse impacts on societies and ecosystems. This study contributed to ongoing discussions about the persistence of critical social issues, even after the investments of large amounts of resources in areas impacted by the construction of large hydropower dams. Our study focused on food insecurity and evaluated this issue in the city of Altamira in the Brazilian Amazon, which has been profoundly socially and economically impacted by the construction, between 2011 and 2015, of Brazil's second-largest dam, namely, Belo Monte. A survey in Altamira city featured a 500-household random sample. Structural equation modeling showed conditioning factors of 60% of the population experiencing varying food insecurity degrees. Poverty, female-led households, lower education, youth, and unemployment were strongly linked to higher food insecurity. Crowded, officially impacted, and resettled households also faced heightened food insecurity. Our findings underscore the food insecurity conditions in the region impacted by the Belo Monte dam, emphasizing the need to take into account this crucial issue while planning and implementing hydropower dams.

Quality of life and socio-demographic factors associated with nutritional risk in Brazilian community-dwelling individuals aged 80 and over: cluster analysis and ensemble methods

Introduction

The aim of the present study was to use cluster analysis and ensemble methods to evaluate the association between quality of life, socio-demographic factors to predict nutritional risk in community-dwelling Brazilians aged 80 and over.

Methods

This cross-sectional study included 104 individuals, both sexes, from different community locations. Firstly, the participants answered the sociodemographic questionnaire, and were sampled for anthropometric data. Subsequently, the Mini-Mental State Examination (MMSE) was applied, and Mini Nutritional Assessment Questionnaire (MAN) was used to evaluate their nutritional status. Finally, quality of life (QoL) was assessed by a brief version of World Health Organizations' Quality of Life (WHOQOL-BREF) questionnaire and its older adults' version (WHOQOL-OLD).

Results

The K-means algorithm was used to identify clusters of individuals regarding quality-of-life characteristics. In addition, Random Forest (RF) and eXtreme Gradient Boosting (XGBoost) algorithms were used to predict nutritional risk. Four major clusters were derived. Although there was a higher proportion of individuals aged 80 and over with nutritional risk in cluster 2 and a lower proportion in cluster 3, there was no statistically significant association. Cluster 1 showed the highest scores for psychological, social, and environmental domains, while cluster 4 exhibited the worst scores for the social and environmental domains of WHOQOL-BREF and for autonomy, past, present, and future activities, and intimacy of WHOQOL-OLD.

Conclusion

Handgrip, household income, and MMSE were the most important predictors of nutritional. On the other hand, sex, self-reported health, and number of teeth showed the lowest levels of influence in the construction of models to evaluate nutritional risk. Taken together, there was no association between clusters based on quality-of-life domains and nutritional risk, however, predictive models can be used as a complementary tool to evaluate nutritional risk in individuals aged 80 and over.

Gender, skin color, and household composition explain inequities in household food insecurity in Brazil

It is well known that female-headed households (FHHs) are more likely to experience food insecurity (FI) than male-headed households (MHHs), however there is a dearth of evidence on how gender intersects with other social determinants of FI. Thus, this paper investigated changes in the prevalence of household FI in Brazil from 2004 to 2018 by the intersection of gender, race/skin color and marital status of the household reference person. Data from three cross-sectional nationally representative surveys that assessed the status of FI using the Brazilian Household Food Insecurity Measurement Scale were analyzed (N2004 = 107,731; N2013 = 115,108, N2018 = 57,204). Multinomial logistic regression models were used to examine the relationship between profiles of gender, race/skin color, marital status of the head of the household with household FI stratified by the presence of children <5 years of age. Over time, FHHs had a higher prevalence of mild and moderate/severe FI than did households headed by men. Food security prevalence increased from 2004 to 2013 and decreased between 2013 and 2018 for households headed by men and women. In 2018, households headed by black/brown single mothers with children < 5 years of age were at the highest FI risk. The probability of reporting moderate/severe FI in these households were 4.17 times higher (95% CI [2.96-5.90]) than for households headed by married white men. The presence of children in the household was associated with a higher probability of moderate/severe FI, especially for households headed by black/brown individuals regardless of the reference person's gender. The results suggest that gender inequities combined with darker skin color and the presence of children at home potentiate the risk of moderate/severe FI. Policy makers need to consider the principles of intersectionality when investing in codesigning, implementing, evaluating, and scaling up evidence-based programs to reduce FI.

Food insecurity and social inequalities in households headed by older people in Brazil: a secondary cross-sectional analysis of a national survey

BACKGROUND

The presence of food insecurity in households headed by older people is related to social inequalities. The objective of this study was to analyze the prevalence and factors associated with moderate/severe food insecurity in households headed by older people.

METHODS

A cross-sectional study based on a nationally representative sample of older adults aged ≥ 60 years was conducted using data from the 2017/2018 Family Budget Survey. In the study, moderate/severe food insecurity was the dependent variable, with food insecurity assessed with the Brazilian Household Food Insecurity Measurement Scale. Prevalence and odds ratio estimates were generated with 99% confidence intervals. Data analysis was performed using STATA software.

FINDINGS

A total of 16,314 households headed by older people were identified. Approximately 10.1% of these households were in the moderate/severe range for food insecurity. The majority are female (11.9%)and self-declared indigenous people (25.5%), with a lack of schooling (18.3%) and a per capita income of up to half of one minimum wage (29.6%). The analysis model found that color/race, region, schooling, per capita household income, and social benefits received in the household were statistically significant factors (p value < 0.01).

CONCLUSION

Moderate/severe food insecurity in households headed by older people is associated with the pronounced social inequalities present in Brazil, and these findings intensify the need for additional study of the challenges faced by this age group.

Racial disparities in lifestyle habits and dietary patterns in university students during the COVID-19 pandemic

Objectives

To evaluate lifestyle habits and dietary patterns among university students during the COVID-19 pandemic and their association with skin color.

Methods

This cross-sectional study was conducted with 1315 undergraduate students from a public higher education institution. Sociodemographic characteristics, lifestyle habits, and food consumption were collected. Factor analysis was used to identify dietary patterns and multivariate logistic regression was conducted to estimate the associations between race/skin color and outcomes.

Results

Black individuals were less likely to show behaviors associated with the use of cigarettes or tobacco products (OR = 0.61; 95% CI 0.42-0.89). However, black individuals with higher income (greater than, or equal to one minimum wage per person) were less likely to show behaviors associated with illicit drug use (OR = 0.54; 95% CI 0.31-0.96), use of cigarettes or tobacco products (OR = 0.46; 95% CI 0.24-0.87) and alcohol consumption (OR = 0.64; CI 95% 0.42-0.98). In addition, individuals of race/skin color black with lower income (less than one minimum wage per person) showed decreased consumption of vegetables (OR = 0.68; CI 95% 0.48-0.96).

Conclusions

Black college students with higher income were less likely to show undesirable behaviors related to the use of psychoactive substances. In contrast, individuals with lower income had lower consumption of foods from the vegetable group, which can be considered an unfavorable health-related behavior.

Inequalities in food acquisition according to the social profiles of the head of households in Brazil

Abstract Brazil is characterized by strong social inequalities and differences in access to quality food and sufficient quantities of it, which represent a violation of the human right to adequate food. The aim was to assess food expenditures according to the social profiles of the head of the households. Data from the cross-sectional Brazilian Household Budget Survey (2017/2018) were used with a nationally representative sample of household survey participants (n=52,917). Poisson regression was used to estimate prevalence ratios (PR) to assess the association of different social profiles with the acquisition of food. The profile characterized by woman self-classified as white, with a higher education, which characteristics were positively and significantly associated with more acquisition of fruits (PR=1.22; CI95% 1.09-1.36) and vegetables and greens (PR=1.24; CI95% 1.09-1.41). Black women with low education levels showed a negative association with the consumption of soda (PR=0.53; CI95% 0.45-0.62), and prepared food (PR=0.52; CI95% 0.37-0.74). The results reveal great inequalities in the purchase of food between the social profiles of the heads of the family.

Food insecurity and symptoms of anxiety and depression disorder during the COVID- 19 pandemic: COVID-Inconfidentes, a population-based survey

This study aimed to investigate the association between adult food insecurity (FI) and symptoms of generalized anxiety disorder (GAD) and major depressive disorder (MDD) in two Brazilian cities during the coronavirus disease (COVID-19) pandemic. This study used data derived from a cross-sectional survey of 1693 adults. Interviews were conducted using an electronic questionnaire. The FI was measured using the Brazilian Food Insecurity Scale. The Generalized Anxiety Disorder-7 was used to measure the symptoms of GAD. The Patient Health Questionnaire-9 was used for MDD symptoms. The association between FI, GAD, and MDD symptoms was investigated using a Poisson regression model with robust variance to estimate the prevalence ratio and 95% confidence interval (95% CI). In regression models, a linear association between FI levels and outcomes was observed, with severe food insecurity having a 3.56 higher prevalence of GAD symptoms (95% CI: 2.23, 5.68) and a 3.03 higher prevalence of MDD (95% CI: 1.55, 5.90). In the stratified analyses, worse results were observed for females and males, individuals with non-white race/skin color, those without children, and those with lower monthly family income. In conclusion, the FI was associated with symptoms of GAD and MDD, and the sociodemographic characteristics interfered in this association. Therefore, we recommend the improvement of public health and social protection policies for food-insecure people.

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FI was consistently associated with symptoms of GAD and MDD during the pandemic.

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FI is linearly associated with anxiety and depression symptoms.

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Participants at any FI level had more negative feelings (e.g., depressed mood).

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The mental health impact of FI is sensitive to sociodemographic characteristics.

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The results obtained may contribute to the cross-cultural consistency of the theme.